Poisoning Becomes Leading U.S. Cause of Injury Death: What is Spurring the Trend?

Friday, January 20, 2012 - 02:45

A publication from The Centers for Disease Control and Prevention recently revealed that poisoning has overtaken motor vehicle-related fatalities as the number one cause of death in the United States. Over the past 30 years, poisoning death has almost tripled, while the motor vehicle traffic death rate has shrunken by about half. Furthermore, the public safety news source explains that 90% of these poisoning deaths are due to drug poisoning. In 2008, the final year studied in this health report, only about 22% of these deaths were deemed suicides or of “undetermined intent.” The CDC explains this makes around 77% of the drug deaths of 2008 unintentional.

At the heart of these disturbing numbers lie three major culprits. Recent legal developments, limiting the ability to litigate against pharmaceutical companies, present arguably the greatest threat to our ability to change this drug death trend. In addition, some drug benefits simply do not outweigh their hefty side effects, particularly for addictive pain medications. Finally, an all-time high rate of prescription drug abuse has been facilitated by a handful of doctors who dole out the bulk of all narcotic prescriptions.

A recent article from WebMD addressed the unethical doctor dilemma, explaining that 69% of all painkiller prescriptions are handed out by just 3% of American doctors. If a pain pill addict needs to score, many simply now need to make an appointment with their local doctor and drop by the pharmacy, not scour the streets.

One such doctor is Julio Diaz, who was recently arrested for “trafficking in huge quantities of powerful painkillers,” the Associated Press reports. According to this article, though, Diaz’s peers at the Santa Barbara hospital were more surprised with the length of time it took to see law enforcement step in than the arrest itself. Other doctors at the hospital reported seeing large numbers of Diaz’s patients obviously hooked on these prescription painkillers. However, according to DEA records, Diaz is just one of only about 230 doctors since 2003 that have been charged with such a crime, leaving us to question whether enough is being done to curb this disturbing trend and keep Americans safe.

The AP article explains that although Diaz’s name was on the radar of authorities, his medical license remained in good standing. This highlights an obvious flaw in the legal system’s prosecution of drug prescribers when a doctor can accumulate complaints for 15 years and receive peer scrutiny over his actions for four years yet still continue to escape prosecution, not to mention continue to see patients.

With the massive number of drug prescriptions Diaz wrote, many of these pills also made their way to the street, posing a larger problem as more and more individuals were given opportunities to try these drugs and become hooked. Diaz even addressed the problems with prescription drug abusers hitting the streets for these medications, though he did fail to recognize his contribution to this concern. According to comments Diaz made to the Los Angeles Times in defense of his continued prescription of these drugs to obvious addicts, “If you don’t give them the medications, they are going to go to the street.”

Unfortunately, Diaz and other doctors like him apparently disregard the misconceptions and false security a prescription from a doctor can create regarding these medications. The perception, particularly among young prescription drug users, is that because these medications are prescribed by a doctor and dispensed in a legal fashion by a pharmacy, they are somehow safer than illegal substances. In effect, doctors like Diaz condone the abuse of these medications, which is the last thing an addict needs. This is akin to a doctor writing an alcoholic a script for commercially-sold vodka because they fear the patient will turn to illegally-distilled spirits, which simply does not make sense. Obviously, users who believe these prescription pain killers are safe are mistaken, but this helps account for the rise in legal medication deaths seen in the United States recently.

Besides the use and abuse of prescription pain medications, a host of medication recalls and warnings have punctuated the need for greater standards of testing within the pharmaceutical industry and increased public scrutiny when these blockbuster drugs do go wrong. Pharmaceutical companies may possess the funds to heavily promote their products and fight these rising concerns with counter studies, but they should not have the power to silence the victims.

One major prescription drug concern that arose in 2011 was the use of Actos, a prescription medication given to patients with type 2 diabetes. Unfortunately, recent findings have indicated a heightened risk of bladder cancer among those who use the drug the longest. This finding conflicts with an ongoing five-year study of the medication by the manufacturer, Takeda Pharmaceutical Co. According to those study results so far, there is no overall increase in the risk of bladder cancer. Despite the manufacturer’s claims, though, numerous bladder cancer victims continue to come forward after using this medication. Even Germany and France banned the drug following a study which did show a greater risk of bladder cancer.

Although the disconcerting trend in drug deaths has not gone unnoticed, federal attempts to curb this record outbreak have thus far been inadequate. Despite the focus of the Healthy People 2010 campaign, which began in January 2000, the number of fatal poisonings in the United States actually increased during the program’s tracking period. That decade’s nationwide health promotion and disease prevention agenda contained 467 objectives which were to be achieved by the year 2010. Unfortunately, the anticipated drop in drug-related deaths was never seen.

In the years 2007 and 2008, the CDC explains that nearly half of all Americans used at least one prescription drug. Therefore, the idea that a campaign similar to that used to shrink vehicle death numbers will result in a comparable decrease in the number of drug poisoning deaths is naïve. Unlike those efforts, which included clear-cut improvements in the safety of vehicles, roadways, and restraint devices, implementing a “multifaceted approach” to reversing the drug poisoning trend is not so clear cut. Furthermore, these changes will likely be met with heavy opposition from an industry that grosses billions on some questionable medications. With the combination of ample advertising coffers and a potent lobbyist presence in Washington, these pharmaceutical companies will likely fight all attempts to restrict their consumer base, whether that includes changes to the way drugs are prescribed, purchased, or recommended for use.

Nevertheless, 2012 Florida legislation is attempting to improve the protocol for prescribing controlled substances. SB 1198 will make several changes to the way controlled substances are dispensed if it passes. These changes include requiring “consultation with or referral to a psychiatrist, rath er than a physiatrist;” “providing that a prescription is deemed compliant with the standards of practice and is valid for dispensing when a pharmacy receives it;” and ensuring “pain-management clinic[s] register with the Department of Health unless the clinic is wholly owned and operated by certain health care professionals.” With so many Americans already addicted, the most this state regulation can accomplish may only include the limitation of new addicts.

About

Rich Newsome is a civil justice attorney who represents people and families in complex civil litigation. He is the senior partner of the Newsome Melton law firm in Orlando, a former federal prosecutor in the Northern and Middle Districts of Florida, Past-President of the Florida Justice Association, and a member of the Summit Council. Rich currently serves as a Commissioner on Florida's Constitution Revision Commission. For more information visit this page on the firm's website, or follow him on Twitter @RichNewsome.